Abuse after disclosing status hinders HIV care

Date: January 1, 1970
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24-year old Ruth Sibanda* was pregnant and could not wait to have her first baby. On one of her visits to the antenatal clinic, they gave her an HIV test. No one really explained to Sibanda much about the test. She received no pre-test counseling to mentally and psychologically prepare her for the action she is about to take. All they said was that she must get the test done, so that if she tests positive she can get assistance so that she does not infect her unborn child.

As fate would have it, Sibanda tested positive and her world was never the same. When she arrived home and broke the news to her husband, she met with blows and insults. The most terrible thing for her was that, though she had only slept with one man, her husband, he accused her of infidelity and of infecting him with HIV.
More than 25 years into the struggle with HIV and AIDS, and this is just one among many stories of women who have experienced violent behaviour and abuse by their partners after disclosing their HIV status.
“We receive a number of complaints from women who are abused by their partners after disclosing their status,” says Sara Murera, the Programme Assistant, Gender Violence and HIV and AIDS at Musasa Project in Zimbabwe.
“It is women who usually get to know their HIV status first and if they discuss the results with their partners, they are blamed, shamed, threatened and in some cases this can lead to divorce, stigma and discrimination,” she said.
Along with partners and husbands, families also often shun women who disclose their status, placing the blame squarely on the woman’s shoulders. According to the World Health Organization (WHO), among women who disclose their HIV status in sub-Saharan Africa, between three and 15 percent report violent reactions to revealing their status.
“Even in instances where there was no form of violence in the home before, disclosure can ignite violent acts by the partner,” says Murera. “The husband can refuse to share a bed with the wife, even if he does not know who infected who. The blame is always heaped on the wife.”
Murera’s organisation runs support groups for women. Because there are many women who have been in such situations, it is easy to find some willing to come and share their experiences with affected women. “They try to show them that their problem is not unique. They have survived it and have moved on with life.”
Abusing women who disclose their HIV status encourages people to keep their status a secret and fear of testing and its consequences increases the spread of HIV and AIDS.
The WHO estimates that in Sub-Saharan Africa only 17 – 32 percent of women who test positive for HIV reveal their status. Fear of violence and reprisals prevents many women from accessing information on HIV and AIDS, being tested, disclosing their status, accessing services for the prevention of HIV transmission to infants, and receiving treatment, care and support.
The main reason health service providers test women for HIV during pregnancy is to prevent mother-to-child transmission. According to UNICEF, if a woman living with HIV becomes pregnant, there is a 35 percent chance that she will transmit the virus to her child, if there is no preventative action. Some 15 to 20 percent of children become infected during pregnancy while 50 percent are infected during delivery and 33 per cent through breastfeeding.
Yet in pursuing this worthy cause, as in Sibanda’s case, there are times when there are no supportive measures in place to help the woman deal with their newfound knowledge and to ensure that they return for follow up, or even to make them aware of treatment options or positive living messages. Ignoring women’s needs for the sake of the child’s defeats the purpose.
                                                                                                                                                                                              Men who have tested positive for HIV also have fears about disclosing their HIV status. An Ethiopian man who discovered that he was HIV positive started taking antiretroviral drugs, but kept it a secret from his wife. The man told his wife that his anti-retroviral drugs were vitamin tablets and that the doctor had prescribed him a “vitamin” to boost his energy levels because he was always overloaded with work.
He told his wife that the tablets were not good for women’s health. “My husband confessed that he knew his status for three years and did not tell me, fearing that our family and neighbours would discriminate against us. The fact that the virus is sexually transmitted shamed him,” said the 35-year-old woman whose husband died shortly after his confession.
Couples should be encouraged to go for testing and counseling together and to be supportive of each other whatever the results. They should also try to avoid the blame game and instead focus on the way forward and living positively. In the case of women especially, there needs to be more work done to ensure that revealing one’s status is a healthy life choice, and not a catalyst for increased violence and discrimination.
Recognising that underlying gender norms are at the heart of some of the barriers women face in sharing HIV test results with their partners, and in the type of treatment they experience after revealing their status, is key to making headway in preventing and caring for women when it comes to HIV and AIDS.
* Not her real name.
Gloria Ganyani works with Southern Africa HIV and AIDS Information Dissemination Service (SAfAIDS) Media Unit in Zimbabwe. This article is part of a series produced by the Gender Links Opinion and Commentary Service for the Sixteen Days of Activism on Gender Violence.

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